Individual provider Active NPI

William Brent Bush, MD

  • Internal Medicine Physician
  • Linden, TN
National Provider Identifier
1043310337
Registry record updated Feb 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
31181 Issued in TN
Practice address
115 E Brooklyn St
Linden, TN 37096-3515
Phone
(931) 589-2104
NPI assigned
Sep 25, 2006
Last updated
Feb 28, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 31181 TN Primary

Addresses

Primary practice location

115 E Brooklyn St
Linden, TN 37096-3515

Mailing address

PO Box 2705
Suite a
Huntsville, AL 35804-2705
Phone (256) 801-6049

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090812000954 TN Practitioner - Internal Medicine 5395834345 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
HH Health System - Shoals LLC Current Accepting new patients
DX Mso, PLLC CurrentSince May 13, 2017 Accepting new patients
Coffee Medical Group LLC Current Accepting new patients
4MD2 in Patient Physician Services of Decatur LLC Past Accepting new patients

Locations

211 Hospital Rd
Red Bay, AL 35582
Phone (256) 356-8160

700 E 54th St N
Sioux Falls, SD 57104
Phone (423) 458-1426

1025 Peerless Xing NW
Cleveland, TN 37312
Phone (423) 476-5990

170 Mouse Creek Rd NW
Cleveland, TN 37312
Phone (423) 458-1426

1615 McMinnville Hwy
Manchester, TN 37355
Phone (931) 450-5062

482 Interstate Dr
Ste A
Manchester, TN 37355
Phone (931) 450-1106

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582848000000",
    "number": "1043310337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2705",
            "address_2": "SUITE A",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358042705",
            "telephone_number": "256-801-6049",
            "fax_number": "256-801-6218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 E BROOKLYN ST",
            "city": "LINDEN",
            "state": "TN",
            "postal_code": "370963515",
            "telephone_number": "931-589-2104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSH",
        "first_name": "WILLIAM",
        "middle_name": "BRENT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2020-02-28",
        "certification_date": "2020-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "31181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Linden, TN

Sources for this page

Verify at the official NPI Registry.